Irish Journal of Medical Science最新文献

{"title":"A 10-year service evaluation of a Cervical Dystonia Botulinum Toxin A Clinic: factors associated with patient-reported outcomes.","authors":"Maeve Bradley, Margaret Ryan, Fiona Molloy","doi":"10.1007/s11845-025-04019-x","DOIUrl":"https://doi.org/10.1007/s11845-025-04019-x","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of botulinum toxin A (BoNT-A) has been well established for cervical dystonia (CD). In clinical practice, individual injection schemes vary widely.</p><p><strong>Aims: </strong>To examine patient satisfaction of routine care with BoNT-A for CD in a \"real-world\" clinical setting.</p><p><strong>Methods: </strong>Patients with primary CD attending a specialist botulinum toxin clinic were evaluated over a 10-year period (2008-2018). At each clinic visit, patients were asked to complete a questionnaire with a visual analogue score between 0 and 100 to rate their response from the previous injection. Outcomes were recorded as static measurements of the time to reach 50% improvement and 75% improvement. The association between patient factors and outcome were assessed using Fisher exact test and standard t test.</p><p><strong>Results: </strong>Data was recorded for 135 patients attending for 1665 injections over a 10-year period. Overall, 84% of patients achieved 50% improvement (n = 114) and 73% (n = 99) achieved 75% improvement. There was no significant association between gender, head tremor, toxin preparation or head posture with either the likelihood of achieving 50% improvement or the time to achieve 50% improvement. A sensory trick was reported in 82% (n = 111). Those who did not have a sensory trick were more likely to have reported a preceding trauma (62% vs 18%, p = 0.05) and were less likely to achieve 50% improvement.</p><p><strong>Conclusion: </strong>BoNT-A was shown to be safe and effective for CD. The absence of a sensory trick was associated with less response to BoNT-A. Other factors did not show a clear association.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of oxidative stress markers in umbilical cord blood of vaginal and cesarean babies.","authors":"Nur Aycan, Hasan Akduman, Dilek Dilli, Çağanay Soysal, Filiz Akduman, Nurdan Dinlen Fettah, Başak Kaya, Baran Oğuz, Serhat Ege","doi":"10.1007/s11845-025-04031-1","DOIUrl":"https://doi.org/10.1007/s11845-025-04031-1","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress is defined as an imbalance between oxidant and antioxidant substances in favor of oxidants. Despite the well-known adverse effects of oxidative stress on the mother, fetus, and newborn, the impact of birth type on oxidative stress experienced by both mother and child remains unclear.</p><p><strong>Aims: </strong>Our study aimed to investigate the effects of birth type on the oxidant and antioxidant systems through umbilical cord blood analysis.</p><p><strong>Methods: </strong>Between 37 and 41 weeks of gestation, cord blood was collected from 92 newborn babies. Participants were divided into two groups according to their mode of birth: Group Cesarean Section (n = 45) and Group Normal Vaginal Delivery (n = 47). The material used in the study was umbilical cord blood samples collected immediately after birth. Total Antioxidant Status, Total Oxidant Status, thiol, catalase, arylesterase, paraoxonase and stimulated paraoxonase, measurements were determined.</p><p><strong>Results: </strong>Neonatal cord blood thiol levels were significantly lower in both the Cesarean section group (195.60 ± 4.27) compared to the Normal Vaginal Delivery group (212.06 ± 6.01,p = 0.025), and in newborns of mothers with a history of urinary tract infection (189.9 ± 2.8) versus those without (206.26 ± 4.3,p = 0.041). No significant differences were observed in Total Antioxidant Status, Total Oxidant Status, catalase, stimulated paraoxonase, paraoxonase or arylesterase levels across the studied groups.</p><p><strong>Conclusions: </strong>The cesarean birth and maternal urinary tract infection history are associated with significantly reduced neonatal cord blood thiol levels while other oxidative stress markers remain unchanged highlighting thiol's potential role as a sensitive biomarker for birth-related oxidative imbalance and supporting its use in early postnatal risk assessment.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital habits and physical health: a study of screen time and BMI among young healthcare profession students and residents.","authors":"Hooria Rahim, Bilal Ahmad, Khoban Rahim, Zainab Fatima, Ayesha Humayun, Hafiza Asma Nazir, Arzoo Rahim, Maryam Shafiq, Eman Azam, Muhammad Usman","doi":"10.1007/s11845-025-03991-8","DOIUrl":"10.1007/s11845-025-03991-8","url":null,"abstract":"<p><strong>Background: </strong>Average screen time has increased drastically after the COVID-19 pandemic. It has raised concerns about the adverse effects, including the effect on BMI.</p><p><strong>Aim: </strong>The present study is conducted to study the relationship between screen time and BMI among medical students at a medical institute in Lahore, Pakistan.</p><p><strong>Methods: </strong>For this cross-sectional study, a sample of 370 medical students and residents was obtained from a medical institute in Pakistan. An online survey to gather data about screen time activities, device usage, and BMI. Screen time was categorized into low (1-2 h/day), moderate (3-4 h/day), and high (5-6 h/day), while BMI score was calculated and categorized into under-weight, normal, overweight, and obese groups. Descriptive and inferential statistics including Spearman correlation analysis were applied using IBM SPSS 25.0.</p><p><strong>Results: </strong>Most participants fell into the normal BMI category (79%), with a smaller proportion classified as overweight (16%) or obese (5%). Most participants preferred using smartphones (92.1%). About 41% of participants had high screen time. There was a strong positive correlation between low screen time and normal BMI (r = 0.999). However, only 2.9% of the participants had low screen time. The link between higher screen time and obesity is observed especially in males, while females maintain a more stable normal weight, suggesting gender-based lifestyle or metabolic differences.</p><p><strong>Conclusion: </strong>Screen time is significantly associated with BMI with a strong positive correlation as well. There is need to design educational programs to raise awareness about the safe use of devices and the amount of screen time.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1493-1501"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-to-lymphocyte ratio: is it more valuable than CRP in assessing severity of acute diverticulitis at initial presentation? A single-center retrospective cohort study.","authors":"Nurettin Sahin, Ahmet Surek, Turgut Donmez, Ferman Tevfik Ozyalvac, Emine Ayca Sahin, Sina Ferahman, Halil Kirazkaya, Muge Yurdacan, Mahmut Said Degerli, Sezer Bulut, Hamit Ahmet Kabuli, Alpen Yahya Gumusoglu","doi":"10.1007/s11845-025-03983-8","DOIUrl":"10.1007/s11845-025-03983-8","url":null,"abstract":"<p><strong>Aim: </strong>We aim to evaluate the effectiveness of cheap, easily accessible, and simple biomarkers in determining the severity of diverticulitis according to the modified Hinchey classification.</p><p><strong>Method: </strong>Patients were divided into two groups: complicated and uncomplicated diverticulitis. Laboratory test results of the two groups were compared. The same patients were divided into two groups: operated and non-operated patients. Laboratory test results of these two groups were compared.</p><p><strong>Results: </strong>The study included 335 patients. Two hundred twenty patients (65.7%) were classified as having uncomplicated diverticulitis, and 115 patients (34.3%) were classified as having complicated diverticulitis. For CRP, the sensitivity was 53.9%, and the specificity was 69.1% in distinguishing between complicated and uncomplicated diverticulitis patients [AUC 0.648 (0.587-0.709)]. For NLR, the sensitivity was 80.9%, and the specificity was 58.6% [AUC 0.734 (0.678-0.791)]. Forty-nine patients (14.6%) were classified as having operated diverticulitis, and 286 patients (85.4%) were classified as having non-operated diverticulitis. For NLR, the sensitivity was 84.5%, and the specificity was 65.0% in distinguishing between operated and non-operated diverticulitis patients [AUC 0.789 (0.728-0.850)]. For CLR, the sensitivity was 85.7% and the specificity was 53.5% [AUC 0.735(0.664-0.805)].</p><p><strong>Conclusion: </strong>In patients with acute diverticulitis, the NLR value is more successful than the CRP value in distinguishing between complicated and uncomplicated diverticulitis. Similarly, it can effectively predict whether patients with acute diverticulitis will require surgery. In addition, the CLR value predicts the need for surgery in patients with acute diverticulitis with high sensitivity.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1443-1452"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous route is associated with prolonged epinephrine-to-ROSC interval in out-of-hospital cardiac arrest.","authors":"Michael W Hubble, Stephen Taylor, Melisa Martin, Sara Houston, Ginny R Kaplan, Randy D Kearns","doi":"10.1007/s11845-025-03979-4","DOIUrl":"10.1007/s11845-025-03979-4","url":null,"abstract":"<p><strong>Background: </strong>Prolonged resuscitation is associated with poor patient outcomes. While the importance of bystander CPR and early defibrillation is well-known, the role of other components affecting resuscitation duration is less well-established. We postulated that first-dose intraosseous (IO) epinephrine would prolong the pressor-to-ROSC interval compared to intravenous (IV) drug administration.</p><p><strong>Aims: </strong>To describe the relationship between first epinephrine administration route and pressor-to-ROSC intervals.</p><p><strong>Methods: </strong>A retrospective analysis of the 2020 ESO Data Collaborative Annual Research dataset was conducted among adults who experienced non-traumatic, bystander-witnessed arrests. A Cox proportional hazard model was used to determine the influence of first epinephrine route on the pressor-to-ROSC interval. End-of-event was defined as ROSC, field termination of resuscitation, or hospital arrival without ROSC, with right censoring of the latter group.</p><p><strong>Results: </strong>Overall, 9351 patients were included for analysis, of which 63.9% were males. The mean age of participants was 65.3(± 15.5) years and presumed cardiac etiology was present in 82.7% of arrests. An initial shockable rhythm was present in 27.1%, while 29.7% received bystander CPR and 39.7% attained ROSC. The mean pressor-to-ROSC interval was 13.21(± 9.65), 14.86 (± 10.89), and 14.42 (± 10.52) minutes for the intravenous, tibial IO, and humeral IO routes, respectively (p < 0.001). First epinephrine administration via the tibial or humeral IO route was associated with a decreased hazard of ROSC compared to the IV route (HR = 0.78, p < 0.001 and HR = 0.86, p = 0.01 per minute, respectively).</p><p><strong>Conclusions: </strong>These data suggest that the tibial and humeral IO routes of first epinephrine administration were associated with marginally prolonged resuscitation duration after drug administration and decreasing hazard of ROSC.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1453-1460"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitudes towards stress urinary incontinence surgery in Ireland: navigating the pause on mid-urethral sling use.","authors":"Reut Rotem, Muireann Hickey, Daniel Galvin, Suzanne O'Sullivan, Ciaran Brady, Orfhlaith E O'Sullivan","doi":"10.1007/s11845-025-03986-5","DOIUrl":"10.1007/s11845-025-03986-5","url":null,"abstract":"<p><strong>Background: </strong>Mid-urethral slings (MUS) for the surgical management of stress urinary incontinence (SUI) have been suspended in Ireland since July 2018, significantly impacting treatment options and clinical practice.</p><p><strong>Aims: </strong>This study aimed to explore the attitudes of consultant obstetricians, gynaecologists, and urologists in Ireland toward SUI surgery following the MUS suspension, including their prior practices, current approaches, and views on MUS safety and potential reinstatement.</p><p><strong>Methods: </strong>A descriptive, anonymized questionnaire was electronically distributed in early 2023 to consultant members of the Irish Society of Urology and the Continence Foundation of Ireland. Non-consultants, non-medical professionals, and respondents outside Ireland were excluded. Data were analyzed using SPSS v28.</p><p><strong>Results: </strong>Before the 2018 suspension, 89.5% (17/19) of respondents performed SUI surgeries, with 76.5% (13/17) using MUS-retropubic and 53% (9/17) MUS-transobturator techniques. Post-suspension, 63.2% (12/19) continued performing SUI surgery, primarily urethral bulking (83.3%, 10/12). Regarding safety, 83.3% (15/18) believed MUS led to fewer instances of post-operative voiding dysfunction and 66.7% (12/18) reported fewer complications such as vault prolapse or rectocele. Notably, 44.4% (8/18) had been involved in litigation related to MUS. Despite this, 52.6% (10/19) expressed willingness to resume MUS if the suspension was lifted.</p><p><strong>Conclusions: </strong>MUS was the preferred SUI procedure prior to suspension due to perceived safety and effectiveness. Over half of consultants surveyed would consider resuming its use, highlighting a need for diverse, evidence-based treatment options and calling for a re-evaluation of the current suspension.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1485-1491"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive systematic review of prognostic factors, survival outcomes, and the role of targeted therapies in endometrial cancer.","authors":"Ali Raza, Rimsha Abaidullah, Fahad M Alshabrmi, Israr Fatima","doi":"10.1007/s11845-025-03984-7","DOIUrl":"10.1007/s11845-025-03984-7","url":null,"abstract":"<p><strong>Study background and objectives: </strong>Endometrial cancer, ranking as the 6th most prevalent cancer affecting women globally, is characterized by high mortality rates, recurrence, and poor prognosis. The disease lacks comprehensive understanding and effective treatment options. This meta-analysis focuses on randomized controlled trials to investigate targeted therapies, survival outcomes, and prognostic factors in endometrial cancer.</p><p><strong>Methods: </strong>The study follows the PICOS protocol and PRISMA guidelines, utilizing Review Manager Software (Version 5.4) for meta-analyses. Predetermined outcomes relevant to the topic guide the study search, with the GRADE tool assessing the quality of evidence and Begg's formula and Kendall's Tau evaluating certainty.</p><p><strong>Results: </strong>Results reveal oral anastrozole and vistusertib's efficacy, reducing progression-free survival (PFS) and enhancing protein detection. The meta-analysis indicates that targeted therapies do not significantly improve PFS but reduce adverse effects. Chemotherapy does not considerably improve survival rates, and interventions show no significant difference in prognostic factors.</p><p><strong>Conclusion: </strong>In conclusion, anastrozole and vistusertib emerge as effective targeted therapies for endometrial cancer, supported by clinical trial evidence demonstrating reduced PFS and improved protein detection. Additionally, the carboplatin-paclitaxel combination and radiotherapy in monotherapy show promising clinical outcomes. These findings contribute to a comprehensive understanding of prognostic factors, targeted therapies, and survival outcomes in endometrial cancer, emphasizing the need for further research and clinical trials for optimal disease management.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1209-1222"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of IL-17 and IL-23 ınhibitors on hematological ınflammatory parameters in patients with psoriasis vulgaris.","authors":"Mehmet Semih Çelik, Hamza Aktaş","doi":"10.1007/s11845-025-03969-6","DOIUrl":"10.1007/s11845-025-03969-6","url":null,"abstract":"<p><strong>Background and objective: </strong>IL-17 and IL-23 inhibitors are widely used as biological agents in patients with psoriasis vulgaris to suppress inflammation and reduce disease severity. This study aimed to examine changes in inflammatory parameters, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic inflammation index (SII), platelet/hemoglobin ratio (PHR), and red cell distribution width/platelet ratio (RPR), as well as the Psoriasis Area and Severity Index (PASI), in psoriasis patients receiving biological therapy (IL-17 and IL-23 inhibitors).</p><p><strong>Materials and methods: </strong>This retrospective study included 110 patients with psoriasis vulgaris treated with IL-23 (risankizumab, guselkumab or IL-17 inhibitors ( secukinumab, and ixekizumab). Disease severity was assessed using the PASI score. Hematological parameters (NLR, PLR, SII, PHR, and RPR) and PASI values of the patients were recorded and analyzed at baseline (month 0) and during treatment (month 6).</p><p><strong>Results: </strong>A significant decrease was observed in NLR, SII, and PHR values during treatment. NLR decreased significantly from 2.43 ± 1.25 at baseline to 2.12 ± 0.81 at month 6 (p = 0.002). Both IL-17 and IL-23 groups significantly reduced NLR (p = 0.044, p = 0.029, respectively). SII decreased significantly from 695 ± 390 at baseline to 588 ± 288 at month 6 (p = 0.002). Both groups significantly reduced SII levels (p = 0.044, p = 0.018, respectively).PHR decreased significantly from 19.8 ± 6.60 at baseline to 19.2 ± 6.58 at month 6 (p = 0.033).PASI score significantly decreased during treatment (p < 0.001).</p><p><strong>Conclusion: </strong>The significant reduction in NLR and SII levels in both the IL-17 and IL-23 groups suggests that these markers may be used together rather than separately in treatment follow-up. The significant decrease in PHR levels may indicate that IL-17 and IL-23 inhibitors contribute to reducing cardiovascular disease risk in patients with psoriasis vulgaris and promote a favorable long-term prognosis.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1329-1334"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining CT radiomics and radiological features to predict pathological grade in stage I lung adenocarcinoma.","authors":"Lu He, Chunhong Hu","doi":"10.1007/s11845-025-03993-6","DOIUrl":"10.1007/s11845-025-03993-6","url":null,"abstract":"<p><strong>Aims: </strong>While previous studies have explored the use of radiomics or radiological features alone, this study uniquely integrates both feature types within a unified predictive model based on the latest IASLC grading system, thereby enhancing pathological grading accuracy in early-stage invasive lung adenocarcinoma. This study aimed to evaluate the potential of combining CT radiomics with traditional radiological features to non-invasively predict the pathological grade of stage I invasive pulmonary adenocarcinoma according to the International Association for the Study of Lung Cancer (IASLC) new grading system.</p><p><strong>Methods: </strong>A retrospective study was conducted on 240 patients. Radiological features were assessed, and radiomics texture features were selected using mRMR and LASSO. A combined predictive model was constructed using random forest regression, and its diagnostic performance was evaluated using ROC analysis.</p><p><strong>Results: </strong>The CT radiological feature model achieved AUCs of 0.848 in the training set and 0.832 in the validation set. The texture feature model yielded AUCs of 0.850 in the training set and 0.845 in the validation set. The combined predictive model demonstrated superior diagnostic performance with AUCs of 0.902 in the training set and 0.880 in the validation set. The combined model's specificity also exceeded that of the individual models, with specificities of 90.5% and 93.3% in the training and validation sets, respectively.</p><p><strong>Conclusions: </strong>This model improved diagnostic accuracy and demonstrated strong potential for clinical application, advocating for its broader adoption in clinical practice to improve personalized treatment strategies in lung cancer care.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1223-1231"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of CT features and laboratory indicators to aid in the management of patients with portal venous gas identified on imaging.","authors":"Marion Hanley, Munir Saeed, Ronan Lee, Damien C O'Neill, Taranum Naz, Paula Loughlin, Michael J Lee, Martina M Morrin","doi":"10.1007/s11845-025-03998-1","DOIUrl":"10.1007/s11845-025-03998-1","url":null,"abstract":"<p><strong>Background: </strong>It can be difficult to distinguish cases of benign portal venous gas (PVG) that can be managed conservatively from forms associated with ischaemic bowel.</p><p><strong>Purpose: </strong>To identify CT, clinical and laboratory factors that may be assist in the decision-making regarding patient management.</p><p><strong>Methods: </strong>All patients in whom PVG was demonstrated on CT imaging were identified over an 8-year period. CT imaging was reviewed for 19 CT features. Clinical findings and laboratory values also retrospectively reviewed. Patients were divided into four groups based on management and outcomes; Group 1, conservatively managed and died, Group 2, conservatively managed and survived, Group 3, operative management and died and Group 4, operative managed and survived.</p><p><strong>Results: </strong>Fifty-six patients had PVG. Overall mortality rate was 54%. Thirty-four percent of patients underwent surgical exploration. Sixty-six percent of patients were managed conservatively. Serum lactate values were found to be highest in Group 1 and lowest in Group 2 (p < 0.001). Neutrophil/lymphocyte ratios significantly differed across the groups. High serum lactate was associated with significantly increased inpatient hospital mortality. CT features of a stenosed or occluded coeliac artery, stenosed or occluded superior mesenteric artery, bowel obstruction, non-obstructed small bowel dilatation and the presence of ascites were associated with significantly increased inpatient hospital mortality.</p><p><strong>Conclusion: </strong>Management of patients with PVG should be determined by assessing the combination of clinical assessment, laboratory values in addition to CT features. Attention may be given to elevated serum lactate levels and specific CT features associated with higher mortality rates.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"1297-1307"},"PeriodicalIF":1.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}